02 Adding Payers

Payers are defined as the entity that pays your claims. Payers are also known as insurance companies, MCOs, HMOs, PPOs but can also be county agencies, families, group homes, or patients/consumers. The payer is required before services and authorizations can be entered.

1. Click on Billing desktop
2. Click on Payers
3. The payer search window should open automatically, if it does not, click Search Payers.
4. Click Search to ensure the payer you need is not already in OnTarget. We recommend searching by Payer Code or Payer Name. Continue if the payer is not in the list.
5. Click Add Payer.
6. Enter the Payer Code
   1. For electronic billing to a payer, this is the payer ID. If not sure of payer ID, enter a generic code here and reach out to Aym Technologies support or your assigned account analyst.
   2. For generic billing (invoices/paper billing), enter any abbreviation you wish.
7. Enter the Payer Name
   1. For electronic billing, this is the name of the payer exactly as they expect it on the claim file. Ex: Medicare, BCBS of NC, etc
   2. For generic billing (invoices/paper billing), enter the name of the entity who will pay the bills. Ex: Mecklenburg County DSS, ABC Group Home.
8. Enter the Address (Note: Only required if the payer needs it on their invoice/claim)
   1. If address is required, enter full address including zip code.
9. Enter Contact Name and Phone (not required)
10. Select Cash Posting Account
    1. Select the appropriate bank account to post the cash payments received from this payer.
    2. Select 1000 (default) account if your agency has not added specific bank accounts in OnTarget.
11. Select Claim Setting
    1. One Service Date per claim-bills each date of service on a separate claim
    2. Max Lines Per Claim-allows a user to set a maximum number of dates of service on a claim (most payers do not allow more than 30 days)
12. Check both Funding and Authorizing Payer in most cases
    1. Helpful Hint: The only time only one box will be checked is if the payer is NOT both; Funding Payer is who pays the claims; Authorizing Payer is who authorizes the services.
13. Check Overlapping Authorized Service if the payer allows more than one service billed per consumer on the same day. If not sure, do not check.
14. Check Medicare Override if it is payer Medicare only.
15. Override NU function
    1. Please do NOT check this option without reaching out to the account analyst manager or support.
16. Click SAVE.
17. If this is a new electronic payer, notify Aym Technologies so the appropriate enrollment forms can be processed.